Fill and Sign the Petition Settlement Form

IN THE MATTER OF PROBATE NO _______ DIVISION “____” _____ JUDICIAL DISTRICT COURT THE MINORITY OF PARISH OF __________________ __________________ STATE OF LOUISIANA PETITION FOR MINORITY SETTLEMENT The petition of ________________ , a resident of lawful age and domiciled in the Parish of ________________ , State of Louisiana, with respect represents that: 1. Petitioner is the father and natural guardian of the minor child, ________________ . He is still married to and living with ________________ (mother of the minor child). 2. On or about _______ ___ , 20 ___ , plaintiff’s minor son, ________________ , was injured while playing in a space walk at a party hosted by ________________ while playing with another minor child, ________________ , in the Parish of ________________ , State of Louisiana. 3. As a result of said accident, petitioner, individually and on behalf of the minor child, ________________ , has a cause of action against ________________ , ________________ , Individually and as the Tutrix and Administratrix of the Estate of her minor child, ________________ , ________________ , and ________________ for damages including but not limited to personal injuries. 4. Petitioner has been informed by a representative of the defendants, that without any admission of negligence or liability on their part, they are willing to enter into a settlement agreement with the petitioner pursuant to the terms and conditions set forth in the Receipt and Release (attached as an exhibit). 5. Petitioner shows that he is of the opinion and believes that the amount which defendants have agreed to pay in compromise will in some measure compensate him and the minor child for the injuries sustained in the accident. It is in the best interest of petitioner and the minor child to accept said sum from the defendants in compromise and to enter into a receipt and release agreement in the form and substance of the Receipt and Release attached as an exhibit. It is also in the best interest of petitioner and the minor child, to accept the consideration offered by defendants rather than to continue to engage in expensive and risky litigation. Therefore, petitioner requests that this Honorable Court render judgment authorizing and empowering ________________ as the tutor of the minor, ________________ , to make and enter into said compromise agreement for and on behalf of the said minor and to execute the Receipt and Release on behalf of his minor child. WHEREFORE, petitioner prays that: I. Petitioner’s recommendation be homologated; and II. Accordingly, petitioner be authorized, as tutor of the minor child, ________________ , to compromise the minor’s claims against ________________ , ________________ , Individually and as the Tutrix and Administratix of the Estate of her minor child, ________________ , ________________ , and ________________ in accordance with the terms and conditions set forth in the Receipt and Release (attached as an exhibit), and to execute the necessary compromise agreement. RESPECTFULLY SUBMITTED: __________________ ________________ __________ , Louisiana _______ Telephone: __________ Facsimile: ________________ __________ BY: ________________ (LSBA # _______ ) Attorney for ________________ , Individually and as Administrator of the Estate of His Minor Child, ________________ .